ONJ has been increasingly suspected to be a potential complication of bisphosphonate therapy in recent years. Thus, the ASBMR leadership appointed a multidisciplinary task force to address key questions related to case definition, epidemiology, risk factors, diagnostic imaging, clinical management, and future areas for research related to the disorder. This report summarizes the findings and recommendations of the task force. Introduction: The increasing recognition that use of bisphosphonates may be associated with osteonecrosis of the jaw (ONJ) led the leadership of the American Society for Bone and Mineral Research (ASBMR) to appoint a task force to address a number of key questions related to this disorder. Materials and Methods: A multidisciplinary expert group reviewed all pertinent published data on bisphos- phonate-associated ONJ. Food and Drug Administration drug adverse event reports were also reviewed. Results and Conclusions: A case definition was developed so that subsequent studies could report on the same condition. The task force defined ONJ as the presence of exposed bone in the maxillofacial region that did not heal within 8 wk after identification by a health care provider. Based on review of both published and unpublished data, the risk of ONJ associated with oral bisphosphonate therapy for osteoporosis seems to be low, estimated between 1 in 10,000 and <1 in 100,000 patient-treatment years. However, the task force recognized that information on incidence of ONJ is rapidly evolving and that the true incidence may be higher. The risk of ONJ in patients with cancer treated with high doses of intravenous bisphosphonates is clearly higher, in the range of 1-10 per 100 patients (depending on duration of therapy). In the future, improved diagnostic imaging modalities, such as optical coherence tomography or MRI combined with contrast agents and the manipulation of image planes, may identify patients at preclinical or early stages of the disease. Management is largely supportive. A research agenda aimed at filling the considerable gaps in knowledge regarding this disorder was also outlined. J Bone Miner Res 2007;22:1479-1491. Published online on July 19, 2007; doi: 10.1359/JBMR.0707ONJ

http://www.endoexperience.com/documents/BRONJReportofaTaskForceoftheAmerSocofBoneMineralResearch.pdf

Bisphosphonate-associated osteonecrosis of the jaw: Report of a Task Force of the American Society for Bone and Mineral Research

Cone-beam computed tomography (CBCT) systems have been designed for imaging hard tissues of the maxillofacial region. CBCT is capable of providing sub-millimetre resolution in images of high diagnostic quality, with short scanning times (10-70 seconds) and radiation dosages reportedly up to 15 times lower than those of conventional CT scans. Increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a 3-dimensional representation of the maxillofacial skeleton with minimal distortion. This article provides an overview of currently available maxillofacial CBCT systems and reviews the specific application of various CBCT display modes to clinical dental practice.

/pdf/clinical-applications-of-cone-beam-computed-tomography-in-4kp8tgr2p7.pdf

Clinical applications of cone-beam computed tomography in dental practice.

What is Cone-Beam CT and How Does it Work?

http://www.endoexperience.com/documents/DeVos2009.pdf

Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: a systematic review of the literature.

https://www.odontoscan.com.br/imagens/gerais/anexo_562a890d92ee9.pdf

Endodontic Applications of Cone-Beam Volumetric Tomography

Objectives: Radiation doses were determined to balance risks against usefulness of the different modalities available for the imaging of the facial skeleton. Methods: An Alderson Rando Phantom, armed with lithium fluoride thermoluminescent dosemeters (TLDs) was exposed using a set of four conventional radiographs (orbital view, modified Waters view, orthopantomography, skull posterior–anterior 0°), two different cone beam computed tomography (CBCT) (NewTom 9000 and Siremobil Iso-C3D), and multislice computed tomography (CT) modalities (Somatom VolumeZoom and Somatom Sensation 16). TLDs from 14 well defined anatomical sites lying within the primary beam as well as the TLD corresponding to the thyroid gland were evaluated. Results: Multislice CT showed the highest exposure values. Exposure levels of the CBCT sytems lay between CT and conventional radiography. Dose measurement for the 16-slice CT revealed nearly the same radiation exposure as the 4-slice system when adapted examination protocols were used. C...

/pdf/radiation-exposure-during-midfacial-imaging-using-4-and-16-1v054a5ak3.pdf

Radiation exposure during midfacial imaging using 4- and 16-slice computed tomography, cone beam computed tomography systems and conventional radiography

Intraoperative imaging of zygomaticomaxillary complex fractures using a 3D C-arm system.

Objectives: To investigate the usefulness of cone-beam computed tomography (CBCT) in cases of suspected osteomyelitis (OM) of the mandible. Methods: 13 patients with clinical suspected OM of the mandible underwent cone-beam computed tomography with the NewTom QR-DVT 9000. After CBCT revealed signs confirming the diagnosis of OM, biopsies were performed. Only cases in which histology confirmed the OM were included in this study. Results: CBCT sufficiently depicts OM-typical lesions like osteolytic and osteosclerotic areas as well as periosteal reaction, ill-defined cortical borders and sequestra. Conclusions: Because the local extension of the disease and its relationship to anatomic structures can be sufficiently detected by CBCT, we see an important additional indication for the usage of CBCT. With regard to distinct cases CBCT combined with scintigraphy seems to be a sufficient diagnostic strategy concerning suspected OM.

Diagnostic criteria for the detection of mandibular osteomyelitis using cone-beam computed tomography

Objectives: The purpose of this study was to compare three-dimensional (3D) imaging of the facial skeleton using an isocentric mobile C-arm system vs CT. Methods: A dried human skull was scanned using a Siremobil Iso-C3D and a multi-detector CT (SOMATOM Volume Zoom; Siemens Medical Solutions, Erlangen, Germany) to compare reconstructed data sets. For each group of scans a standard protocol and a high resolution protocol were used. Image quality was analysed using six anatomical and six virtual structures in the primary reconstructed axial images of both data sets of the Siremobil Iso-C3D compared with CT. A receiver operating characteristic (ROC) study was performed with six examiners. Results: The original categorical response data revealed no significant differences in sensitivity and specificity \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} \((P{<}0.05).\) \end{document} However, image quality...

3D-imaging of the facial skeleton with an isocentric mobile C-arm system (Siremobil Iso-C3D)

Objectives: More than 50% of all children suffer a traumatic dental injury (TDI) during childhood. In many cases, dentists apply root canal treatment (RCT), which is performed on an average of 7e10 days after replantation. Our aim was to evaluate whether RCT is necessary in many cases, and whether revitalization of affected teeth is possible and measurable by visualization using 3T magnetic resonance imaging

Early detection of pulp necrosis and dental vitality after traumatic dental injuries in children and adolescents by 3-Tesla magnetic resonance imaging

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